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HomeMy WebLinkAboutMortgage_Topper (2) 49,5r,gr STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County Township Year -•`"?.':'., FOR DEDUCTION FROM ASSESSED VALUATION v. ,_ 2020 a •`�:= €s-: State Form 43709(R14/1-20) .5V� +� ..` File Mark a�,_::.f Prescribed by Dep ent of Local Government finance rats INSTRUCTIONS: k l` 2 J ?. � To be filled in person or by mail. rm file with: Filing Dates: Form must be comp! to nd dated in the calend ear r which the d ductio is sought. Must be filed or postmarked with the County Audit r or County Recorder of the county where the property is located on or before January 5 of the calendar year in which the property taxes ae first due County Auditor and payable. 0 County Recorder See reverse side for additional instructions and qualifications. Applicant(owner or contract buyer-see restrictions on reverse side) Chad W.Topper and Staci M.Topper Taxing District Key number legal desc' fon /115 S.2nd Ave., Haubstadt Indiana 47639 Record number Page number - 2� tq-`�-3O( 000 Za A-009 . go- 55 Assessed value of real property as of Mortgage/C ntract Indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is a applicant the sole assessment date,current year assessment date,current year date of application leg I equitable owner? $119,000.00 Yes 0 No If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with who If name on record is different than that of applicant,indicate below: e property in question: Annually Assessed Real Property 0 Annually Assessed Mobile Home(IC 6-1.1-7) Name of mortgagee or contract seller F IR -IEvansville Teachers Federal Credit Union Address of mortgagee or contract seller(number and street,city,state,and ZIP code) 4401 Theater Drive, Evansville, IN 47715 NOV 2 y 2020 Name of assignee or other owner or holder of mortgage • _i Address of assignee(number and street,city,state,and ZIP code) _ /jf_- ' a4 AO IIITOR Does applicant own property in any If yes,what county? What Taxing Dis� SO Has his de uctiol been requested If yes,state amount of other county on property r deduction in Indiana? 0 Yes 0 No current year? Yes 0 No A person is not entitled to this deduction unless the person has a balance on the person's mortgage or co t indebtedness that is recorded in the county recorder's office(including any home equity line of credit that is recorded in the county recorder's office)th is e basis for the deduction. COUNTY AUDITOR Deduction approved in the amount of: 20 20 20 20 20 20 20 Signature my Au 't r County ` Date(Ton dayIto I/We ce I under t e penalt ury that the above a d oregoing information is true and correct and tha a appl cant is a resident of Indiana and owner/contract buyer of the aforementioned property date application is filed. ��Signaturq'(�w er tilll,n me) I lie(rp clay yea (l��lj_Ioj� r s of a icant(number and street,city,sta a ZIP code) / I `/ Full resident address 115 S 2nd Ave., Haubstadt, IN 47639 Person authorized by duly executed Power of Attorney or by IC 6-1.1-12-0.7 'Date(month,day,year) Address of authorized person(number and street,city,state,and ZIP code) The penalties for perjury can include imprisonment up to two and a half years and a fine not to exceed$10,000.